|
Annual alcohol screen 15 min
|
$40.00 |
$40.00 |
$40.00 |
$40.00
|
|
Annual Physical, Established Patient (age 18-39)
|
$212.80 |
$212.80 |
$212.80 |
$153.51
|
|
Annual Physical, Established Patient (age 40-64)
|
$226.40 |
$226.40 |
$226.40 |
$160.73
|
|
Annual Physical, New Patient (age 18-39)
|
$235.20 |
$235.20 |
$235.20 |
$154.00
|
|
Annual Physical, New Patient (age 40-64)
|
$272.80 |
$272.80 |
$272.80 |
$167.25
|
|
Anodyne therapy charges pt
|
$12.80 |
$12.80 |
$12.80 |
$42.00
|
|
Anogenital exam child w imag
|
$345.60 |
$345.60 |
$345.60 |
$277.99
|
|
Anora (draw only)
|
$36.00 |
$36.00 |
$36.00 |
$35.00
|
|
Anorectal myomectomy
|
$906.40 |
$906.40 |
$906.40 |
$4,350.00
|
|
Anoscopy
|
$496.00 |
$496.00 |
$496.00 |
$1,278.72
|
|
Anoscopy ablation lesion 46615
|
$396.00 |
$396.00 |
$396.00 |
$3,245.23
|
|
Anoscopy and biopsy
|
$625.60 |
$625.60 |
$625.60 |
$2,288.00
|
|
Anoscopy and dilation 46604
|
$1,621.60 |
$1,621.60 |
$1,621.60 |
$1,645.43
|
|
Anoscopy control bleeding 46614
|
$361.60 |
$361.60 |
$361.60 |
$2,140.60
|
|
Anoscopy remove fb 46608
|
$1,313.97 |
$1,313.97 |
$1,313.97 |
$1,375.98
|
|
Anoscopy remove lesion 46610
|
$622.40 |
$622.40 |
$622.40 |
$3,816.64
|
|
Anoscopy remove lesions w/cautery/snare 46612
|
$755.20 |
$755.20 |
$755.20 |
$3,816.64
|
|
Ans parasymp & symp w/tilt
|
$329.60 |
$329.60 |
$329.60 |
$368.50
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$1,513.60 |
$1,513.60 |
$1,513.60 |
$5,841.60
|
|
Anthrax vaccine sc or im
|
$156.80 |
$156.80 |
$156.80 |
$322.00
|
|
Antibody
|
$38.40 |
$38.40 |
$38.40 |
$38.40
|
|
Antibody bacterium, not elsewhere specified
|
$48.57 |
$48.57 |
$48.57 |
$57.85
|
|
Antibody elution rbc reference
|
$156.24 |
$156.24 |
$156.24 |
$177.29
|
|
Antibody htlv/hiv confirm test
|
$48.57 |
$48.57 |
$48.57 |
$131.56
|
|
Antibody htlv-i
|
$48.57 |
$48.57 |
$48.57 |
$49.53
|
|
Antibody htlv-ii
|
$28.00 |
$28.00 |
$28.00 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$48.57 |
$48.57 |
$48.57 |
$224.00
|
|
Antibody id rbc panel
|
$328.79 |
$328.79 |
$328.79 |
$291.75
|
|
Antibody influenza virus
|
$48.57 |
$48.57 |
$48.57 |
$54.00
|
|
Antibody lymphocytic choriomeningitis
|
$48.57 |
$48.57 |
$48.57 |
$46.58
|
|
Antibody screen rbc
|
$57.14 |
$57.14 |
$57.14 |
$108.55
|
|
Antibody tetanus
|
$48.57 |
$48.57 |
$48.57 |
$54.15
|
|
Anticoag mgmt pt warfarin
|
$26.40 |
$26.40 |
$26.40 |
$26.40
|
|
Antidepressant not specified
|
$72.14 |
$72.14 |
$72.14 |
$72.14
|
|
Antidepressants class 3-5
|
$72.14 |
$72.14 |
$72.14 |
$72.14
|
|
Antidepressants class 6/more
|
$72.14 |
$72.14 |
$72.14 |
$25.35
|
|
Antidepressant tricyclic 3-5
|
$23.20 |
$23.20 |
$23.20 |
$23.20
|
|
Antiepileptics nos 4-6
|
$12.80 |
$12.80 |
$12.80 |
$16.24
|
|
Antiepileptics nos 7/more
|
$12.80 |
$12.80 |
$12.80 |
$16.24
|
|
Antigen therapy services
|
$92.00 |
$92.00 |
$92.00 |
$73.84
|
|
Antigen therapy services
|
$168.80 |
$168.80 |
$168.80 |
$83.72
|
|
Antigen therapy services
|
$169.60 |
$169.60 |
$169.60 |
$101.40
|
|
Antigen therapy services
|
$247.20 |
$247.20 |
$247.20 |
$96.72
|
|
Antigen therapy services
|
$328.80 |
$328.80 |
$328.80 |
$130.00
|
|
Antigen therapy services
|
$43.20 |
$43.20 |
$43.20 |
$74.00
|
|
Antigen therapy services
|
$32.80 |
$32.80 |
$32.80 |
$64.39
|
|
Anti mog serum - sendout
|
$48.57 |
$48.57 |
$48.57 |
$132.60
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$48.57 |
$48.57 |
$48.57 |
$38.50
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$48.57 |
$48.57 |
$48.57 |
$42.00
|
|
Ant instr 2-3 vert segm 22845
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$1,748.00
|
|
Ant instrumentation/4-7 vert seg 22846
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
$1,430.40
|
|
Antinuclear antibodies
|
$48.57 |
$48.57 |
$48.57 |
$90.00
|
|
Antinuclear antibodies titer
|
$48.57 |
$48.57 |
$48.57 |
$80.04
|
|
Antiphosphatidylserine antibody
|
$48.57 |
$48.57 |
$48.57 |
$67.43
|
|
Antipsychotics nos 1-3
|
$72.14 |
$72.14 |
$72.14 |
$136.61
|
|
Antipsychotics nos 4-6
|
$36.00 |
$36.00 |
$36.00 |
$16.24
|
|
Antipsychotics nos 7/more
|
$12.80 |
$12.80 |
$12.80 |
$16.24
|
|
Antistreptolysin o screen
|
$48.57 |
$48.57 |
$48.57 |
$58.56
|
|
Antistreptolysin o titer
|
$48.57 |
$48.57 |
$48.57 |
$54.00
|
|
Antithrombin iii activity
|
$32.85 |
$32.85 |
$32.85 |
$115.15
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$2,172.80 |
$2,172.80 |
$2,172.80 |
$4,155.20
|
|
Ant sgm img ir flrscn angrph
|
$322.40 |
$322.40 |
$322.40 |
$322.40
|
|
Ant sgm img i&r speclr mic
|
$90.40 |
$90.40 |
$90.40 |
$286.00
|
|
Ant thrc vrt body tethrg <7
|
$4,508.80 |
$4,508.80 |
$4,508.80 |
$4,508.80
|
|
Ant thrc vrt body tethrg 8+
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
$4,968.00
|
|
Aortic Aneurysm Screening Ultrasound
|
$515.30 |
$515.30 |
$515.30 |
$394.55
|
|
Aortic circulation assist 33971
|
$1,719.20 |
$1,719.20 |
$1,719.20 |
$1,719.20
|
|
Aortic dysfunction/dilation
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,153.60
|
|
Aortic dysfunction/dilation
|
$2,700.80 |
$2,700.80 |
$2,700.80 |
$1,700.16
|
|
Aortic hemiarch graft 33866
|
$2,260.80 |
$2,260.80 |
$2,260.80 |
$2,609.60
|
|
Apc gene dup/delet variants
|
$400.00 |
$400.00 |
$400.00 |
$462.00
|
|
Apc gene full sequence
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,255.20
|
|
Apc gene known fam variants
|
$268.80 |
$268.80 |
$268.80 |
$319.20
|
|
Aphakia prosth service temp
|
$25.60 |
$25.60 |
$25.60 |
$81.12
|
|
Apheresis immunoads slctv
|
$4,728.80 |
$4,728.80 |
$4,728.80 |
$5,794.21
|
|
Apheresis plasma
|
$3,498.41 |
$3,498.41 |
$3,498.41 |
$3,226.34
|
|
Apheresis platelets
|
$275.20 |
$275.20 |
$275.20 |
$2,195.00
|
|
Apheresis rbc
|
$277.60 |
$277.60 |
$277.60 |
$3,290.80
|
|
Apheresis wbc
|
$1,765.23 |
$1,765.23 |
$1,765.23 |
$3,347.60
|
|
Apl(pml-rara) quant - sendout
|
$465.60 |
$465.60 |
$465.60 |
$513.00
|
|
Appendectomy
|
$1,576.80 |
$1,576.80 |
$1,576.80 |
$5,681.93
|
|
Appendectomy add-on 44955
|
$206.40 |
$206.40 |
$206.40 |
$206.40
|
|
Appendectomy/open/rup/w/absc/peri 44960
|
$2,149.60 |
$2,149.60 |
$2,149.60 |
$1,562.44
|
|
Appendix Removal (Laparoscopic)
|
$1,472.80 |
$1,472.80 |
$1,472.80 |
$7,202.00
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$4,291.24 |
$4,291.24 |
$4,291.24 |
$2,114.00
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,716.70 |
$1,716.70 |
$1,716.70 |
$852.00
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,716.70 |
$1,716.70 |
$1,716.70 |
$502.00
|
|
App high cost ss t/a/l >100sq cm 1st 100sq cm
|
$7,073.49 |
$7,073.49 |
$7,073.49 |
$3,593.46
|
|
App high cost ss t/a/l >100sq cm addl 100sq cm
|
$2,199.00 |
$2,199.00 |
$2,199.00 |
$1,146.48
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$1,399.37 |
$1,399.37 |
$1,399.37 |
$512.20
|
|
Appl bdy cst sho to hip 1thi
|
$682.40 |
$682.40 |
$682.40 |
$353.60
|
|
Appl bdy cst sho to hip b th
|
$748.00 |
$748.00 |
$748.00 |
$561.60
|
|
Appl bdy cst sho to hip head
|
$696.00 |
$696.00 |
$696.00 |
$561.60
|
|
Appl body cast sho to hips
|
$608.00 |
$608.00 |
$608.00 |
$509.60
|
|
Appl cast figure-of-eight
|
$237.60 |
$237.60 |
$237.60 |
$314.28
|
|
Appl cast plaster velpeau
|
$298.40 |
$298.40 |
$298.40 |
$314.28
|
|
Appl cast shoulder spica
|
$530.40 |
$530.40 |
$530.40 |
$486.03
|
|
Appl halo type body cast
|
$808.80 |
$808.80 |
$808.80 |
$561.60
|
|
Appl hip spica cast1&1/2
|
$654.40 |
$654.40 |
$654.40 |
$501.28
|
|
Appl hip spica cast 1 leg
|
$590.40 |
$590.40 |
$590.40 |
$499.20
|